Blankenship, Mary Louise

Blankenship, Mary Louise is an individual health care provider with primary practice located at 3188 Southern Blvd Se Ste B1 , Rio Rancho NM 87124-1989. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Blankenship, Mary Louise can be contacted via phone (505) 200-9158.

Contact Information

Primary practice address
3188 Southern Blvd Se Ste B1 Rio Rancho NM 87124-1989
Phone: (505) 200-9158
Fax: (505) 200-9497
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 0375722 New Mexico
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 2023150476 New Mexico

Profile Details

NPI number 1356358477
LBN Legal business name Blankenship, Mary Louise
Credentials RN, FNP, PMHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2006
Last updated Dec 12th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356358477 NPPES
Texas MEDICAID 3017279-01
Texas MEDICAID 77056396

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